Nutrasweet (Aspartame) & Pregnancy

Occasionally the statement is made that 'the effects of Nutrasweet on the fetus are undocumented'.  In either case,
I try to respond with facts, not opinion.  While searching for more on-line documents that deal with this subject, I ran across the following that I thought others might be interested in.

  "Aspartame is safe for use during pregnancy, with the exception of women with
   phenylketonuria. Reproduction studies in laboratory animals show that
   consumption of aspartame at intake levels of at least three times the 99th
   percentile pose no risk to the mother or fetus (28-30). Of the three
   metabolites of aspartame, aspartate seems to be of little concern during
   pregnancy because it does not cross the placenta at anything less than
   enormous amounts. Phenylalanine does cross the placenta, but it is highly
   unlikely that customary intake could raise fetal levels close to the
   neurotoxic range. Little is known about placental transfer and fetal effects
   of methanol; however, the amount of methanol ingested is very small."

 Pitkin RN. Aspartame ingestion during pregnancy. In: Stegink LD Filer LJ
      Jr, eds . Aspartame: Physiology and Biochemistry. New York, NY: Marcel Dekker;
      1984: 555-563.
 Sturtevant FM. Use of aspartame during pregnancy. Int J Fertil.
      1985;30:85-87.
 London RS. Saccharin and aspartameare they safe to consume during
      pregnancy? J Reprod Med.1988; 33:17-21.
 
Paul
----
F. Paul Adams, Jr.
adams@kona.wes.army.mil
 

Caffeine and Fertility

First, a few comments from the net, FWIW:

"I saw one of those brief factoid columns in Child magazine (Oct 94?)
that described a caffeine study at Yale that also indicated increased risk of miscarriage for
women who consumed the equivalent of 3 or more cups of coffee per day.
        Terri "
 
:Jill Walker writes:
: > Last week I think someone mentioned that staying away from caffeine was even more
: > important in the months before you conceive than while you're pregnant.

: > Does the caffeine lower the chance of conception? Or does it  stay in the body so
: > long that it harms the fetus?
[snip]
:
:   The study was done at Harvard Medical school (I think) with 2000 women.
:   For those who consumed caffeine (coffee, sodas, etc.), 27% had a harder
:   time conceiving than those who didn't ... or something that. There was
:   also an increased risk of miscarriage, I think about 17%, for those
:   who continued to consume caffeine.
:        Cindy Swearingen

And, so, I quit drinking coffee (mostly because my periods were, shall we say, suicidally uncomfortable?), and one month later, after doing nothing different than usual, BAM!  Preggo.  We weren't even trying.  So I personally now think that there indeed is something to it.  As well as the fact that the roasting of coffee turns it carcinogenic, and it is teratogenic as well (can cause birth defects).  Don't get me wrong, though; I love it.  I just won't touch it until after the birth, if I want it then.  I'm not finding it a hardship at all.
        Robin
 

> FWIW, I have noticed a correlation between my quitting caffeine and
> longer cycles.  When I quit drinking regular coffee my cycles get
> longer!  Or so it seems -- I can make no scientific claims here.

"I truly believe that anyone experiencing cycle irregularity or any type of infertility should reduce caffeine-containing foods, drugs and beverages to the equivalent of one to two cups of coffee per week," says Marilyn Shannon in Fertility Cycles and Nutrition (referenced on our resources page).  There are 18 other references to caffeine, and a medical study showing the effects.

Sounds pretty severe, but she has treated infertile coffee hounds (6-7 cups a day) successfully. She's also overcome migraine by cutting the caffeine and sugar and taking folic acid. Caffeine is a trigger for some people. So is stopping it abruptly.

You can see it's a complex subject. Whatever you try, keep track of it on your chart and you can hopefully correlate it all some day. Like, what hormones are peaking when the migraine comes, or how much caffeine triggers/prevents the delayed ovulation?  That's pretty strange.  If your pre-ovulation temps are low, you could be a little low in thyroid, and the coffee lights your fire, so to speak.
    ---ed.
 

Breast vs Bottle

>I've seen alot in this newsgroup PUSHING breastfeeding and basically implying
>that by choosing to bottlefeed your baby you are doing them a great injustice,
>threatening their health, not bonding etc. etc.

>PLEASE - making the decision to bottlefeed, for ANY reason, be it health,
>personal, whatever, it is a very difficult decision to make and has enough
>guilt associated with it.  I had to give up feeding my daughter for health
>reasons when she was not much more than a week old.  I lay awake at night
>worrying about what I was robbing her of, and all because of the pushing of
>"Breast is Best".  Some mothers would be quite surprised to hear that she is
>an extremely healthy, thriving, little girl, and the bond between us is really
>quite special.  A bottlefed baby is held in the exact same position as a
>breastfed baby, with the same eye contact and closeness.  If I want skin to
>skin contact with her I can sit and cuddle her to my chest.  Its the same
>thing.

>So when you're criticising bottle-feeders, please just sit for a minute and
>think about the fact that breastfeeding simply doesn't work out for everyone.

>Nicole Stals
 

Human milk and artificial baby milk are not equivalent.  Hundreds of medical studies have been done on the differing health consequences of breastfeeding and formula-feeding.  The results are unanimous: every study shows significantly greater instances of illness among artificially-fed babies, even where clean water, adequate supplies of formula and modern medical care are available.  Some of these illnesses are minor and easily curable and some of them are extremely rare regardless of feeding method.   Some of them are fairly common and fairly serious (gastroenteritis and pneumonia, among them). . And the impact appears to be life-long: several studies have shown a significant influence on adult illness rates (e.g., both pre-and post-menopausal breast cancer are 25% less common among the population of adult women who were breastfed as infants) . To see a small sample of the medical literature showing that formula is an inferior substitute for human milk, visit:

http://www.clark.net/pub/activist/bfpage/why_bf.html

I want to be absolutely clear that I am NOT saying that all, or even most, formula-fed babies are sick.  Nor am I saying that all breastfed babies are healthy.  The studies I am pointing to are epidemiological in nature.  When researchers look at different feeding methods among populations and compare disease rates among them, they have consistently found higher disease rates
among the population that was fed substitutes for human milk.

Should we hide this information from all pregnant women because some will choose to, or be forced by circumstance to, use formula?  Should we pretend that a choice to use formula is a pure lifestyle decision, without any consequences for infant health?  I think not.

The fact that it makes some people uncomfortable to hear this suggests to me that they feel uncertain about the use of an inferior substitute.  Perhaps they did not thoroughly research whether or not continued nursing was possible.  A lot of women are told that they must wean when, in fact, their medical condition and/or medications have not been shown to interfere in with a healthy
breastfeeding relationship.  Short of a double-mastectomy or the use of chemotherapy drugs, and a very short list of other ailments and medications, breastfeeding can and should be continued for the good of both the mother and the baby.  Perhaps they actually welcomed an excuse to wean because it made them uncomfortable to use their breasts to feed their babies.

Our choices whether to feed our babies human milk or artificial baby milk have a significant cumulative impact on public health.  If that fact makes some mothers feel guilty, then maybe they should feel guilty.  Guilt is, after all, a healthy recognition of shortcomings.  People who smoke are made to feel guilty for their choices.  People who eat too much fat and don't exercise are made to feel guilty for their choices.  Maybe a little guilt in this area is called for, as part of a public health education strategy.

Rachael Hamlet
Visit The Breastfeeding Advocacy Page:
http://www.clark.net/pub/activist/bfpage/bfpage.html

{There are plenty more breastfeeding web pages around.---ed. }
 

"MORE sex may be the answer!

"Good news for couples trying to conceive. If you and your husband are having difficulty getting pregnant because of his low sperm count, current research suggests that a pleasant change of strategy may be in order. Instead of  having sex less frequently to "save up the sperm," several recent studies on male infertility have shown that men with weak sperm or low sperm counts actually increase  the chance of  conception when they have sex more often. So try having intercourse every day or even twice a day at the time of ovulation."
        "First for women" magazine, 2/27/95, p.29. Author/editor unattributed.

This is not an accepted scholarly journal ("PSYCHICS:  Are you getting your money's worth?"), but it may have some validity. Sometimes a woman's vaginal chemistry makes it hostile to sperm during the fertile phase, but existing seminal fluid can change the chemistry to buffer it to make it less hostile. Another theory is that men with low sperm counts will generate more with more frequent sex.  For the majority of infertile couples, the rules for increasing your fertility (abstinence during the early phase 2, then every other night when fertile muscus starts, among other things) in The Art of NFP have met with good success.

Milk Consumption and Fertility

Cycle irregularities or infertility, early menopause, PMS and recurrent vaginal yeast infections may involve milk consumption, according to recent medical research. Studies have shown that a sugar unique to milk, galactose, is harmful to ovarian function. When lactose, the ordinary milk sugar, is ingested, galactose is one of the products absorbed into the blood. This galactose is harmful to the developing, unfertilized egg. The liver converts this galactose into glucose (blood sugar), but some women do not convert it well. Such women develop early menopause.

One study showed a link between PMS and women who consumed an average of 3.5 "dairy servings" a day, vs. 2 servings a day in women without PMS. The milk's high calcium to magnesium ratio was faulted; magnesium is important in preventing PMS.

In another study, limiting sugar and milk resulted in great improvement in the frequency of vaginal yeast infections.

Marilyn Shannon, author of "Fertility, Cycles and Nutrition", reports on the above (incl. medical references) and makes specific recommendations for nutritional adjustment in the Nov-Dec 1997 issue of CCL Family Foundations. I am not going to type the whole article here...but if you are experiencing the above problems you can cut down (not out) on milk (not yogurt) for a few
months to see what happens. A subscriptions to Family Foundations (which is 75% fertility- infertility articles) and membership in CCL is $20 a year. It's a non-profit org for natural family planning.

Address:
Couple to Couple League
PO Box 111184
Cincinnati OH 45211

IUD's

>I am considering an IUD and would appreciate any insight from anyone on
>this subject. I did have one about 15 years ago and I got a bacterial
>infection upon insertion. I swore that I'd never put myself through that
>again, but have been told that this kind of infection is uncommon.
...
> Does anyone out there have anything positive or negative that they would like
>to share about IUDs? Thanks in advance
>

First of all, they are abortifacients. that's how they work. This is not a morality lecture, but most people are not apprised of that fact by their doctor.

They are dangerous, which is why they were taken off the market (billions of dollars of lawsuits). I hear that now you have to sign a waiver resolving everyone involved (except you) of all liability. That was how they "fixed" the problem. Hey, you didn't get a perforated uterus or something, so why complain????.....It can also scar the uterus so that fertility is difficult or impossible to regain.

And it's no protection against STD's.

Our own choice of birth control is 100% safe, healthy, cheap, 99.5% effective (as good as Pills), and good for relationships.

Hyperprolactinism

Prolactin is the nursing hormone that suppresses ovulation. Normally this just spaces your children a few years apart, but when it is produced abnormally, without nursing, it can cause unwanted  infertility. There's quite a discussion of prolactin and fertility in Marilyn Shannon's book, Fertility Cycles and Nutrition. While the rest of the book deals with nutrition related to other cycle problems, she has this to say on prolactin (I will leave out the references):

"Vitamin B6 alone (200-600 mg/day) has lowered prolactin levels and restored regular cycles to women with the severe overproduction of prolactin which causes both amenorrhea and galactorrhea (milk in the breasts of non-nursing women)...(you shouldn't be able to squeeeze out so much as a drop, but it is common.)

"...B6 was given in 100-800 mg/day doses to 14 women who had normal menstrual cycles but also had PMS and infertility of 18 mos. to 7 years duration. ...12 of the women conceived, eleven within 6 months of the B6 therapy. In this study, prolactin levels were not found to change, but progesterone levels were significantly increased in several women, indicating that the B6 had improved their luteal function." (Progesterone levels are reflected in basal body temperature after ovulation. Hypothyroidism reduces BBT over the whole cycle.)

"The hypothalamus controls prolactin primarily through inhibition, not stimulation, and prolactin will rise abnormally if it is not properly controlled. Dopamine is the 'prolactin-inhibiting factor'. B6 reduces prolactin levels through stimulation of dopamine production. Magnesium is also necessary for dopamine synthesis... Zinc may also suppress prolactin levels.... Hypoglycemia is a potent stimulus for prolactin release." Hypoglycemia's symptoms are faintness, craving sweets, heart pounding, fatigue, headache, and PMS. (BTW, there are 4 kinds of PMS!)

The above suggests that the prolactin per se is not the cause of infertility, but a cause of low progesterone and therefore poor luteal function. The B6 restores the progesterone and thus fertility.

She also says generous amounts of magnesium (800-1000 mg/day) may make less B6 necessary, and calcium reduces the uptake of Mg. Suitable formulated supplements are Optivite, available in many pharmacies, and Procycle from Madison Pharmacy Associates (800-558-7046). They have 50 mg/tab of B6, so an appropriate dose can be experimentally determined; also, they have the desired 1:2 ratio of Ca to Mg for maximum uptake. Ordinary vitamin supplements do not have the higher ratios of B6 necessary and have not been shown to have any effect.

Reported toxicity of B6 starts at 400 mg/day, so be careful. The Doctor who formulated Optivite suggests starting with a medium dose to see its effect then adjust to the lowest amount that is effective.

We've seen first and second hand (in our students) the effects minute forces have on cycles and fertility. Things like stress, underweight, nutrition, caffeine, low thyroid, even light. Truly amazing, yet also frustrating at times. But at least we know something of what's going on through our knowledge of normal cycles.

Ecological Nursing

"This story is from CNN.com, May 1999.  Yet another another article which supports the notion that the natural spacing afforded by ecological nursing -- 18 to 23 mo. between pregnancies -- is best.  There are a couple of quotes in there from doctors that are obviously contraceptive-mentality based, but the info about the study is really great!
 Erin"
  ---
ATLANTA (CNN) -- Spacing your kids 2 1/2 years apart may be ideal for producing healthy, full-term babies, according to a study that found a sound medical basis for what many women are doing already, for altogether different reasons.

A study by the Centers for Disease Control and Prevention found that while having babies too close together can be bad for an infant's health, having them too far apart may be even worse. Both situations raise the risk that the new baby will be premature or small, which can cause long-term health problems, even death.

The CDC study calculated that waiting 18 to 23 months after giving birth to get pregnant again is best. That works out to about 2 1/2 years between children. "Somehow the body knows that this interval is good for the health of the infant," said Dr. Bao-Ping Zhu, who directed the study. "The delivery is like running for the marathon. You don't want to have two deliveries too close together ... otherwise the body will be tired and the birth outcomes are not likely to be good," Zhu said. "On the other hand, you don't want to wait too long, either."

Many parents already space their children a couple of years apart. That way, they won't have two children in diapers and the youngsters will be close enough in age to play together when they get older. Compared with babies born during the ideal interval, those whose moms became pregnant again within six months had a 30 percent to 40 percent greater chance of producing premature or undersize babies. Those who waited 10 years for another child were twice as likely to have an unusually small baby and 50 percent more likely to deliver prematurely.

The study was based on 173,205 births in Utah from 1989 to 1996. The results were published in Thursday's New England Journal of Medicine. Dozens of previous studies have linked short intervals with a higher risk of small and premature infants, although none determined the best interval. The few studies on long-interval births were less consistent in their findings.

Zhu said babies conceived too soon probably have problems because the mother is recovering from vitamin depletion, blood loss and reproductive system damage from the prior birth -- all while stressed by having to care for a newborn. He theorized that the reason getting pregnant after a long interval is risky is that the body becomes primed for birth during the earlier pregnancy, with the uterus enlarging and blood flow to the womb increasing, but those benefits decline over time.

Dr. Robert A. Knuppel, chairman of obstetrics at Robert Wood Johnson Medical School in New Brunswick, New Jersey, noted that 90 percent of the Utah women were white, so the results may not apply to minority mothers or those with high-risk pregnancies. Zhu agrees, and is conducting a parallel study in Michigan.

The researchers took into account 16 factors that could affect outcomes, such as smoking and drinking, prenatal care and the mother's age, race and education. However, in an accompanying editorial, Dr. Mark A. Klebanoff of the National Institutes of Health cautioned that the researchers might have missed some other factors that could contribute to the risks of conceiving too soon or too long after delivery. These include such things as whether the mother had chronic medical problems, planned the pregnancy or had a miscarriage or abortion since the last birth.

Among American women, the average interval between first and second births is about 2 1/2 years, according to Susan Tew, a spokeswoman for the Alan Guttmacher Institute, a reproductive health organization in New York.  The American College of Obstetricians and Gynecologists says that waiting 1 1/2 to two  years between births is best.

Telling mothers about this information could help reduce health complications in babies, Knuppel said. But the reality is that many other factors come into play when planning a family. And, regardless of timing, the odds for a healthy baby are high if the mother stays fit and healthy.

"I think the best time to have another child is when it is right for you, your work situation, your family situation, kids ..." said perinatologist Dr. Chip Hamner. "That can be just as important a decision-maker as any study that gets published."

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